Risk Perception, Sexual Behaviors, and PrEP Adherence Among Substance-Using Men Who Have Sex with Men: a Qualitative Study

Background: In Kenya and elsewhere in sub-Saharan Africa, young women are disproportionately affected by the HIV epidemic compared to young men. The extent to which young women's self-perceptions about risk of HIV acquisition influence their sexual behaviors and use of HIV prevention methods remains unclear. We therefore conducted a qualitative study to explore these issues among young women enrolled in a pre-exposure prophylaxis (PrEP) trial.Methods: From January 2017 to January 2020, we conducted serial semi-structured in-depth interviews 50 purposively selected young women (18–24 years old) who were participating in the MPYA (Monitoring PrEP for Young Adult women) study—a randomized controlled trial in Thika and Kisumu, Kenya, assessing the impact of SMS reminders on PrEP adherence. Interviews were conducted at three time points (~1 week, 3, and 12 months after initiating PrEP). We used an inductive, content analytic approach to identify key themes related to risk perceptions, sexual behavior, and use of HIV prevention tools.Results: Around the time of enrollment, most of the 50 women interviewed reported being at high risk of HIV because of their own sexual behaviors, such as inconsistent condom use, multiple sexual partners, and transactional sex. Additionally, high risk perception was based on the behavior of their partners, such as refusing to use condoms and being unsure of their partner's HIV status. Young women's perceived risk of HIV acquisition was a key motivator for PrEP initiation and continuation. During PrEP use, participants reported feeling protected and at less risk compared to peers who were not taking PrEP. Some reported no longer using condoms because they were confident that PrEP provided enough protection. Over time, many young women reported reducing risky sexual behaviors because of the regular counseling and HIV testing they received as part of their PrEP services. This lowered risk perception was in most cases accompanied by discontinuation of PrEP.Conclusions: HIV risk perception among young women in Kenya was dynamic and influenced their use of PrEP and condoms over time, suggesting an often-deliberate approach to HIV prevention and sexual health.

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Love and Intimacy as Vulnerability to HIV Infection: A Case Study of MSM

Social Work Chronicle ◽

10.21863/swc/2016.5.1.007 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Archana Kaushik

Keyword(s):

Hiv Infection ◽

Cultural Values ◽

Sexual Behaviors ◽

Sex Workers ◽

Sexual Minorities ◽

Suicide Attempts ◽

Service Providers ◽

Structural Barriers ◽

Health Seeking ◽

Sex With Men

Sexual minorities are among the most marginalized groups in the society. Sero-positivity accentuates social exclusion among the sexual minorities. The paper aims to appraise the factors that make Men who have Sex with Men (MSM) vulnerable to HIV infection and influence their health seeking behaviors. It highlights two major domains socio-cultural and interpersonal variables. Qualitative in nature and based on ten in-depth case studies of HIV infected MSM, the study is located in Delhi, India. Factors such as age, marital status, child sexual abuse, multiple sex partners, are crucial in influencing their vulnerability. Socio-cultural milieu puts structural barriers restricting integration of MSM in the society. Cultural values do not allow talking about sex, which hampers healthy sexual behaviors. Exhibiting aggression, sexual violence, visiting sex-workers etc. are considered as important aspects to prove manhood. At the interpersonal level, possessiveness, betrayal, infidelity, heartbreak, strong emotional whirlpool when love-relations go incongruent, all takes a heavy toll of their mental and physical health. These variables socially exclude the sexual minorities from the mainstream life. Findings show positive (disclosing to family, abstinence, spiritual growth) and negative (suicide-attempts, drug-use) ways of coping among the MSM respondents. Critical areas of concern for service-providers while planning interventions for empowering people with sexual minority are delineated.

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Measuring HIV Risk Perception and Behavior: Results from Round 1 of the Cognitive Interviewing Project with young women and men who have sex with men in South Africa

AIDS and Behavior ◽

10.1007/s10461-020-02790-9 ◽

2020 ◽

Vol 24 (8) ◽

pp. 2307-2318

Author(s):

Jessica Milne ◽

Hannah Brady ◽

Thembekile Shato ◽

Danielle Bohn ◽

Makhosazana Mdladla ◽

...

Keyword(s):

South Africa ◽

Risk Perception ◽

Young Women ◽

Hiv Risk ◽

Cognitive Interviewing ◽

Hiv Risk Perception ◽

Sex With Men ◽

And Behavior

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Use of multiple recreational drugs is associated with new HIV infections among men who have sex with men in China: a multicenter cross-sectional survey

BMC Public Health ◽

10.1186/s12889-021-10223-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiang Mao ◽

Sequoia I. Leuba ◽

Qinghai Hu ◽

Hongjing Yan ◽

Zhe Wang ◽

...

Keyword(s):

High Risk ◽

Hiv Infection ◽

Risk Behaviors ◽

Sexual Behaviors ◽

Hiv Infections ◽

Recreational Drugs ◽

Limited Information ◽

High Risk Behaviors ◽

Sex With Men ◽

Recent Hiv Infection

Abstract Background There is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition. Methods We recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection. Results A total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26–30 years (vs. 18–25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1–599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5–3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs. Conclusion The level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.

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Barriers and Facilitators to Promoting Resilience to HIV/AIDS: A Qualitative Study on the Lived Experiences of HIV-Positive, Racial and Ethnic Minority, Middle-Aged and Older Men Who Have Sex with Men from Ontario, Canada

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158084 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8084

Author(s):

Renato M. Liboro ◽

Sherry Bell ◽

Brandon Ranuschio ◽

Lianne Barnes ◽

Jenna Despres ◽

...

Keyword(s):

Qualitative Study ◽

Ethnic Minority ◽

Lived Experiences ◽

Barriers And Facilitators ◽

Research Approach ◽

Middle Aged ◽

Community Based ◽

Sex With Men ◽

Racial And Ethnic Minority ◽

Hiv Aids

Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n = 24) discussed in their interviews barriers and facilitators to promoting resilience to HIV/AIDS, which they recognized from their lived experiences. Utilizing thematic analysis, themes related to barriers and facilitators to promoting resilience to HIV/AIDS were identified. Themes related to identified barriers included: (1) language proficiency, (2) racism, (3) pernicious norms in North American gay culture, and (4) HIV stigma. Themes related to identified facilitators included: (1) compartmentalization, (2) perseverance, and (3) community-based health and social services. This article discusses the implications of the study’s findings, particularly on how they may influence the development of future services for racial and ethnic minority, middle-aged and older MSMLWH.

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Perceptions of Hospitality and Safety Are Two Sides of the Same Coin

Buildings ◽

10.3390/buildings11030113 ◽

2021 ◽

Vol 11 (3) ◽

pp. 113

Author(s):

Brenda Groen ◽

Hester van Sprang

Keyword(s):

Risk Perception ◽

Qualitative Study ◽

Critical Incidents ◽

Security Measures ◽

Security Officer ◽

Physical Environments ◽

Aggregated Model ◽

Perception Of Care ◽

Two Sides ◽

Reception Area

Entering a building is a ‘moment of truth’ and may invoke feelings of hospitableness. Physical environments and staff behaviour deliver ‘clues’ that may result in the experience of hospitality. The focus in a reception area may be on mitigation of risks, or on a hospitable atmosphere, with either a host or a security officer at the entrance. However, the division of tasks to either the pleasing host or the controlling security officer to a certain extent disavows the overlap between perceptions of hospitality and safety. This exploratory qualitative study combines a group interview with three managers responsible for hospitality and security in reception areas and Critical Incidents by staff and visitors (N = 51). Thematic coding was based on The Egg Aggregated Model and the Experience of Hospitality Scale. Results show that hospitality and safety are indeed two sides of the same coin. Usually people do accept security measures, provided that staff act in a hospitable way. A lack of security measures may seem ‘inviting’, but also decreases the perception of care for your visitor, and may cause uncertainty and therefore decrease comfort. A correct risk perception, flexible appliance of security measures, and a friendly approach connect aspects of ‘safe’ and ‘hospitable’ sentiments.

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